Starting only with a T-Blocker?

[OCTrisha]

I had my first consultation with my endocrinologist this week.  It was a good discussion in terms of my history and where I'm looking to go.  In short, I'm 40 years old and have spent most of my life trying to suppress the dysphoria.  In the last couple of years, I've started opening up and acknowledging these feelings and am now finally considering HRT as a means of treatment.  I told my doctor that I'm still not sure if or when I want to socially transition, so I am naturally concerned about "too much too fast" at this point. 

She explained that these feelings are common and said one possibility would be to start me out on a T-Blocker only regime to start.  Her thinking was that by taking away some of the testosterone, my estrogen levels would be relatively higher.  And this would also come at the benefit of not adding any feminizing effects that adding estrogen would have. 

My hesitation about this would be that this would leave in some sort of gender-netherworld with the worst parts of both genders... I'm not looking to be less masculine.  Rather, I want to become more feminine.  And if I am going to go this far in terms of altering some of my hormone levels, I'm inevitably going to need to see for myself at some point how the estrogen feels.  I genuinely want the more emotional feelings (for lack of a better description) tied to estrogen.

Of course, a lot of this depends on my initial blood work and more conversation with my doctor on the follow-up visit, so I'm still trying to consider all aspects of this. 

Has anyone else tried a T-blocker-only treatment?  Successes?  Failures?  (I did a search, but couldn't find anything quite on point.)

Thanks,
Trish

[JeanetteLW]

Hi Trisha,
  Welcome to Susan's Place. Come on in, have a seat, and get comfortable. You're home now.
  Although I started  with both a T blocker and estrogen my self, I feel you should go with what your endo suggested because it will afford you the slower start that you said you wanted. If you haven't spoke to one already you might consider talking with a gender therapist also. A gender therapist can help you explore those  feelings and dobts you may have and help you understand things better.  They will not judge nor tell you what to do.
  I welcome you and wish you a sedate pace as you embark on what is hopefully a happy journey.

  Hugs,
    Jeanette

[KayXo]

On only a T blocker, you will have low testosterone so that if you don't take enough estrogen to compensate, you might encounter the following symptoms:

- osteoporosis
- brain fog, lack of concentration
- tiredness, lack of motivation/drive
- memory problems, over time increased risk of Alzheimer's, Parkinson's
- anxiety, depression, irritability
- ageing faster
- weight gain
- increased risk of diabetes type 2, over time
- very low libido

The outlook is not so good on low sex hormones. You need to discuss this thoroughly with a doctor that has knowledge in this matter and understands the risks associated with low sex hormones.

[AshleyP]

On only a T blocker, you will have low testosterone so that if you don't take enough estrogen to compensate, you might encounter the following symptoms:

Kay is right and the dosage has a lot to do with how soon those effects will show and how severe they are. I would also add loss of upper body strength and some breast tissue growth, although you could probably lump that under aging. I took what I've seen listed as a HT "starter" dose of spiro for CHF for many years. It took years, but I had some of those side effects.

My hesitation about this would be that this would leave in some sort of gender-netherworld with the worst parts of both genders... I'm not looking to be less masculine.  Rather, I want to become more feminine.

I'm not quite sure that I get that. I could be wrong, but I don't think it works that way.

And if I am going to go this far in terms of altering some of my hormone levels, I'm inevitably going to need to see for myself at some point how the estrogen feels.  I genuinely want the more emotional feelings (for lack of a better description) tied to estrogen.

It's probably best discussed in a different thread, but I've sorta come to the conclusion that the "emotional" or "mental" aspect of HT may have a lot to do with the severity your anxiety, dysphoria or whatever. This is just based on anecdotal input from reading and hearing others' experiences. I've seen posts that practically describe a giddy euphoria almost instantly after popping that first pill. I'm being a little over dramatic, but you know what I mean; it's all in your mind anyway.

I can't speak for the long term mental aspects which may be different; I'm told that it is. I'm only three months on HT, and I've seen little in that respect.

All the best,
--AshleyP

[Maybebaby56]

Hi Trisha,

If it makes you feel any better, that's exactly how I was started out for my hormone therapy - on the lowest possible dose of spiro, with no estradiol. I had waited three months for my first endo appointment, bursting-at-the-seams ready to start estrogen, and that was the net result, the lowest possible dose of spironolactone.

Six weeks later, my endo doubled the spiro dose, and added one patch a week of a twice-a-week transdermal estradiol. Six weeks after that, he doubled the spiro again, and then allowed me to do one patch twice a week.

We went along like that for ten months with this incremental approach, and by the end of that time my serum E2 was barely above the male range.  He is now my former endocrinologist.

My current endo was more in tune with my wishes, but it still has taken some cajoling to get where I want to go. My estradiol dose is much higher, but I still can't convince him to prescribe me progesterone.  I tell myself, "patience, grasshopper", but it is still hard.

With kindness,

Terri
   

[OCTrisha]

Thanks for the feedback, everyone. 

To clarify, my doctor did say she is willing to go at the pace I am comfortable with and offered the T-blocker-only schedule as an option, so I don't think that suggestion is set in stone. 

And I'm still deciding whether I want to actually start the HRT process at all right now.  I know how I'm leaning, but I intend on gathering as much information as I can before I ultimately decide one way or another.

[RobynD]

My hesitation about this would be that this would leave in some sort of gender-netherworld with the worst parts of both genders... I'm not looking to be less masculine.  Rather, I want to become more feminine. 

Has anyone else tried a T-blocker-only treatment?  Successes?  Failures?  (I did a search, but couldn't find anything quite on point.)

Thanks,
Trish

The feminine/masculine goal you articulated fascinates me and i'd love to know more if you are willing to share. It seems to me that hormonally, to feminize is to de-masculinize.

I was on a t-blocker only briefly before estrogen (about 2-2.5 months). I did see some feminization type changes and certainly got the other parts of the drug (having to pee much more often), but understanding that my body definitely needs sex hormones and looking forward to more feminization, i was eager to get on Estrogen.